What is the Heart Attack Composite Outcome Risk (HACOR) score?

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Last updated: February 19, 2025View editorial policy

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From the Research

Definition of HACOR Score

The HACOR score is a rating scale that takes into account several clinical and laboratory parameters, including:

  • Heart rate (H)
  • Acidosis (A)
  • Consciousness (C)
  • Oxygenation (O)
  • Respiratory rate (R) 1, 2, 3, 4, 5

Components of HACOR Score

The HACOR score is calculated based on the following components:

  • Heart rate: measured in beats per minute
  • Acidosis: assessed by pH levels
  • Consciousness: assessed by Glasgow coma score
  • Oxygenation: measured by PaO2/FiO2 ratio
  • Respiratory rate: measured in breaths per minute 2, 3, 4

Prediction of Clinical Outcomes

The HACOR score has been used to predict adverse clinical outcomes in patients with various respiratory conditions, including:

  • COVID-19-related acute respiratory failure
  • Chronic obstructive pulmonary disease (COPD) with pulmonary encephalopathy
  • Acute-on-chronic respiratory failure in non-COPD patients
  • Acute hypoxemic respiratory failure 1, 2, 3, 4

Cutoff Values and Predictive Power

Different studies have reported various cutoff values for the HACOR score, including:

  • 5 for predicting in-hospital death or need for intubation in COVID-19 patients

  • 10.5 for predicting non-invasive ventilation failure in COPD patients with pulmonary encephalopathy

  • 6 for predicting high-flow nasal oxygen failure in patients with acute hypoxemic respiratory failure 1, 2, 4

Clinical Utility

The HACOR score has been shown to be a clinically useful tool for predicting the need for intubation and mortality in patients with respiratory failure, and can help identify patients who are likely to respond to non-invasive ventilation. 3, 5

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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